Men's Health > Prostate Cancer > Who Develops Prostate Cancer

Who Gets prostate Cancer

Every man is at risk for prostate cancer. Fame and fortune provide no exemption - just ask Senators John Kerry and Bob Dole, former New York City Mayor Rudolph Giuliani, Yankees manager Joe Torre, FBI director Robert Mueller, Gen. Norman Schwarzkopf, golf legend Arnold Palmer, South Africa's Nelson Mandela and Desmond Tutu, Federal Reserve chairman Alan Greenspan, or such entertainers as Sean Connery, Harry Belafonte, Merv Griffin, Ed Asner, Sidney Poitier and Jerry Lewis.

It strikes athletes and accountants, statesmen and physicians, celebrities and ordinary guys. It's a rare man, in fact, who does not have a friend or relative with the disease. In all, about 221,000 Americans will be diagnosed with prostate cancer this year, making it the most common internal malignancy in men.

Any man can get prostate cancer, but some have a higher risk than others. While a number of risk factors come with the territory, others can be modified to improve a man's odds. Where do you stand in terms of risk - and how can you reduce your chances of developing this distressingly common disease?

Prostate Cancer Risk factors

Here's a rundown of the factors that contribute to your risk of prostate cancer.

Age. Age is the strongest predictor of risk. Prostate cancer is rare in men younger than 40 and quite uncommon in 40- to 50-year-olds. Above age 50, however, the likelihood of developing the disease begins to rise, and it continues to rise throughout life. The incidence of prostate cancer, in fact, increases faster with age than any other major malignancy.

It's a bit scary: If you live long enough, you probably will get prostate cancer. Remember, though, that most of the prostate cancers in these surveys are clinically unimportant - a few malignant cells discovered in the course of complete autopsies on men who died from other causes. In all, an American man's lifetime risk of developing early microscopic prostate cancer is about 30 percent, but his risk of clinically evident prostate cancer is only about 9 percent, and his risk of dying from the disease is about 3 percent.

Family history. Epidemiologists tell us that the risk of developing any given disease is relative; they also say that when it comes to prostate cancer, having relatives with the disease increases a man's risk. A man whose father or brother had clinically diagnosed prostate cancer is about 1 1/2 to three times as likely to develop the disease as men whose families are free of it; affected uncles and cousins have a much smaller impact than fathers and brothers. But a strong family history increases the risk even more. A man who has several close relatives with prostate cancer - particularly if it was diagnosed before age 55 - is up to five times more likely to develop it himself.

Nationality. The incidence of prostate cancer varies enormously around the world. Even after correcting for age and diagnostic accuracy, it is 120 times more common in San Francisco than in rural China, and more than four times more common in the United States than in Japan.

Race. Prostate cancer is more common in black than in white American men, even after accounting for age, socioeconomic factors, and access to medical care and testing. Most studies estimate that African-Americans have a 30 percent higher risk than Caucasians. Genetics, of course, may account for some of these differences, but lifestyle factors, particularly diet, also play a role. That's why African-American men have a substantially higher prevalence of prostate cancer than black men in Africa or Asia.

Diet. It's the most important risk factor you can control. The leading culprit is saturated fat from animal sources such as meat and whole dairy products. But other foods appear to reduce risk: Tomatoes and other vegetables, soy, whole grains, nuts and seeds, and fish are all on the "good" list.

Jim Shaw